Friday, November 30, 2007

Continuing

Not much has changed since my last post. One step forward was that I followed through on my idea to bathe him at 9pm instead of during the day. I am usually dead-dog tired at that time of night and it's not my idea of a good time, but the plan was to experiment and see if he would sleep a longer stretch. It worked. He slept straight through until 1:30am instead of waking before midnight. *AND* he did it in his bassinet on his back, instead of prone on my chest. So much more relaxing for me to be able to sleep in any position and turn over. I had trouble getting back to sleep because dh and I are still getting over colds and coughing at night, but it was very successful. He then slept through 4:30am and after that nursing we stayed in the recliner and dozed until 6:30, when I needed to wake up ds for school. I did not want to get up at that point. It was raining hard (very unusual) and I was so cozy and warm with A all snuggled up on my chest. I do like dozing along with him, but it's nice to have a break and sleep alone, too.

I have some opinions on how to establish breastfeeding with a newborn, and I want to mention them. I know most of the ladies reading here are expert breastfeeders and don't need my advice, but I'm going to put a label below that might come up on a google search and perhaps my thoughts will help a beginner.

HOW TO BREASTFEED:

Step 1. In the hospital. Bring Lansinoh goop in a tube and smear a little bit, about the size of half a pea, onto your nipple just prior to the first latch after they hand you the baby. If you do this, you may be able to avoid the initial soreness that comes on like gangbusters at the *second* feeding. Make sure baby opens his/her mouth as wide as possible and flatten the breast into a little oval, crosswise to the baby's mouth, and present it like a sandwich. That way you get the nipple in as deep as possible to avoid baby sucking on the tip and hopefully avoiding more soreness issues. If you do get cracked, bleeding, scabbed-up nipples, understand that you can continue to breastfeed despite the scabs. Just work harder to get the nipple in farther, repeat the steps above, if the latch is more painful than usual, or if the pain doesn't subside after a few minutes of nursing, take the baby off and try to latch better, with a wider mouth and deeper nipple.

Step 2. Home with baby. My milk usually doesn't "come in" until day 3 or so. So expect baby to be hungry and fussy for the first few days. Know that baby is getting colostrum. Even a tiny amount of colostrum is very very healthy for baby. It is loaded with immunities and acts to help clear the black-tar poop out of their system. The sooner the black tar gets out of them, the sooner any jaundice/bilirubin issues will be resolved. Resist the urge to use a pacifier or give formula. Plastic nipples are the first step toward quitting breastfeeding. Same goes for nipple shields. Once baby gets a taste for plastic, it can be darned near impossible to get them back on the breast. All of my baby's pacifying was done on the breast. Despite sore/scabbed nipples. I knew he was getting colostrom/early milk every time, and I knew it was good for him.

Step 3. Milk comes in. There will be parts of your breast that become engorged. Some of the ducts may not empty as well as others. Frequent nursing is a way to help alleviate engorgement. If you can nurse frequently and keep most of the breast tissue soft, then you will avoid having your milk supply cut back on you. If your breast becomes painfully engorged and hard to the touch, know that it will get better on it's own in a few days, but that process will involve a drastic reduction in milk supply from the engorged duct areas. I was lucky with this little one. He was able to nurse for long periods, even while dozing, and he was able to empty my breast fairly well for a newborn. Many newborns are sleepy, and you may need to stimulate them to nurse better and not start to sleep after a few sucks. This is done by unwrapping them from the swaddle, or even undressing them from their clothes altogether. Whatever it takes. In a week or so their appetite will improve. And you want your milk supply to be there for them when that happens.

Step 4. Building up milk supply. Now is not the time for a drastic diet. Baby's appetite increases during the early weeks/months, and you need to increase your supply to keep up. This should happen without you even realizing. You might simply notice that baby's diapers are getting fuller and heavier over the weeks. If you see that your breasts seem "empty" and baby still wants to nurse more, go ahead and nurse. The breasts are never empty. And the extra nursing will stimulate more milk production. Also, remember to drink frequently. You should probably have a nice, tall drink every time you sit down to nurse. And eat healthy food and snacks. Never go hungry. And take your vitamins and extra calcium.

Step 5. Extra questions and other circumstances. Get yourself a support system. Get some good books. The Womanly Art of Breastfeeding is a good one. It is the central book put out by the La Leche League. Join La Leche in your area, or seek help from a lactation consultant. It is even better to get to know your support people in late pregnancy, since the first week is the hardest, and it is easier to get help from people you already know. Keep an eye out for baby's diapers. The baby should have pee pee and poo poo in his/her diaper frequently. If this is not happening, seek help right away. Remember, the most important thing is to nourish the baby. Of course, the baby will not be filling up too many diapers until after the milk comes in, but after that if you don't notice a big change, seek help from your doc or lactation consultant right away. Breastfeeding is great, but nourishing the baby is the MOST IMPORTANT thing above all, and don't let pride stop you from making sure your baby is getting the food he/she needs. Just like we all want a natural birth but we are willing to have a c-section for the health of the baby, we all want to breastfeed but we are willing to use formula if it is necessary for the health of the baby. I heard of a case where a woman who had had breast reduction surgery exclusively breastfed her baby and the baby ended up starving to death. Inexcusable. If a mom is paying attention to diapers and the baby's weight, that should NEVER happen.

Verification. The baby should be back up to its birth weight by the 2-week pediatrician appointment. Very successful babies can be a full pound over the birth weight by then.

Don't take baby off the breast too early. The hind milk is the richest milk. If the baby only gets the early stuff and pops off too soon, then they will get "too much soup and not enough cheesecake" somebody said. So let them doze and suck as long as they want, getting multiple let-downs of milk if possible.

Sunday, November 25, 2007

busy with baby



Here are 2 pictures that illustrate what I have been doing the past few weeks. Nursing and caring for baby. The first pic shows A nursing. He is an avid nurser. I weighed him yesterday and he was 8.2 pounds with his clothes on. I am so proud of both of us. Proud of him because he is really a great nurser. He does not fall asleep after several sucks as some babies do. He can go 30 minutes on each breast while he is dozing, and continue to get more and more milk, especially the rich hindmilk, as the milk lets down again and again. And I'm proud of myself, because I am still struggling with soreness, and I don't let that interfere with nursing. The soreness is getting less and less, but at the first latch-on, it still feels like stepping into a hot bath with an open sore on one's foot. Ouch! Tomorrow is his actual due date. Yay! So from now on he will start getting more "mature" instead of going through his fetal development. I am looking forward to seeing his smile in another month or so. You will be the second to know. ;-) I'll try to get a pic when that happens.

Monday, November 19, 2007

Breastfeeding Success!

Baby A weighed in at 7 pounds 3 ounces on his 2-week check up today. That is really good! If you recall, he was 6 pounds 4 ounces at birth, then by the 3rd day he was down to 5 pounds 14 ounces. They want the babies back up to their birth weight by 2 weeks. We exceeded that by almost a full pound! Woohoo! I must be producing cream. :-D

Saturday, November 17, 2007

My daughter and her boyfriend


I forgot to mention that dd and her boyfriend dropped by last weekend while they were on their way back to Camp Pendleton to see baby A. They looked so cute together. DD is now 19 and her boyfriend just turned 21. He has been on 2 tours of Iraq since they started dating 2 or 3 years ago. He just signed on for one more year and another tour of the middle east. They look remarkably well rested considering they were out late the night before at the military ball in San Diego, then drove north to his parent's early the next morning for some sort of Veteran's Day observance where he was honored for his service (hence he showed up in uniform).

Friday, November 16, 2007

I'm a new woman

I forgot what my personality was like before I got pregnant. I don't do well with pregnancy hormones. The high levels of progesterone make me anxious and snappish, like a bad case of pms for 9 months. It is very hard to be nice around the house to my family during that time, especially at the end of pregnancy when walking around the house becomes a chore, much less bending over to pick up after everybody.

But now everything is better. I have so much more patience. When ds asks me questions, it is so much easier to respond kindly and even to suggest ways he can "help" me in the kitchen, etc, even if his help means things take a bit longer. It is good for him and for the family. Maybe it is a mixture of lower hormones and higher prolactin. I'm a super-mothering machine. ;-)

Thursday, November 15, 2007

Getting organized



I am finally feeling more organized, and like I can handle my life. What I mean is, I was able to run a few errands with the baby yesterday, and it wasn't as bad as I feared. He cried a lot less in his carseat than I imagined he would. And he was a picture of contentment in his sling, which I used when picking up the boys at school and at La Leche League.

Speaking of La Leche, I had a moment there where I thought of my online friends. Well, a couple of moments. There was a pregnant mom sitting next to me who told me that she was due any minute. I asked her exact due date and she said November 18. I said, "oh my gosh! I was due November 26! You are due BEFORE ME!" Well hopefully her time will be here soon. She will be tandem nursing her baby with her toddler. But I remember feeling the frustration with my other pregnancies as time went on. I was so shocked to give birth early this time. Definitely not like me. But my fears did not come true about an early birth. I knew the pushing would be easier with a small child, but I worried that nursing would be SO painful. Well, I did have some soreness, but that has almost completely gone away now and things are going well. I even weighed him on our home scale using the subtraction technique, and he was 7 pounds even with his clothes on. So maybe he is 6.5+ pounds without clothes, meaning that he has surpassed his birth weight 0f 6.25 pounds (he was down to 5 14 last Wednesday). He feels heavier.

I took a pic of myself with A in the Moby Wrap. I love the Moby Wrap. And he loves it too. It is now my favorite carrier. He is my contented little snuggle baby, just like I had hoped. :-D

Monday, November 12, 2007

Back in blue jeans


Here I am today, day 8, in my fat jeans. These are size 10. Two more sizes to go for the size 6'es.

Sunday, November 11, 2007

peaceful

Friday, November 9, 2007

typing one-handed

with my left hand! A is nursing great. Still painful at latch, but improving. his bilirubin was 10.4 on day 3, which was good. anything under 12 is good. my cbc showed plenty of hemoglobin ans rbc's. thing is, the second day I came down with a sore throat. the whole family has a cold. great timing, huh? sunday is bris, or circumcision. tons to do here. no time for posting. i will update more later.

Wednesday, November 7, 2007

postpartum bleeding and lactation

My milk is really coming in today. I think I might try to pump what A doesn't eat for himself. I don't want to lose my abundant supply because of his youth and inexperience. ;-)

I passed a clot yesterday the size of a walnut. And there was one I found the day before the size of a pistachio nut. I wonder if there was retained tissue from the placenta. In 5 prior kids, I have never passed tissue like that before. The good news is that after that happened, the bleeding finally slowed down and the cramping is about 1/4 of what it was. The bad news is that I think I might have lost a lot of blood. We are going to get a CBC run on me today to make sure I have enough red blood cells and to make sure the white count is not too high. I also have night sweats, but that could be from the changing hormones, not necessarily a uterine infection. I have been a little dizzy the past 2 days upon standing up. Good thing I am not driving a car this week. My neighbors, MIL and everybody is pitching in to help get the kids to and from their classes so I don't have to drive. And MIL is driving all the way from Los Angeles, a 1-hour drive to take me to the well baby visit and the lab.

The well-baby visit will figure out what is going on with A's weight and bilirubin. They do a scan of his skin color with some sort of device. Not as exact as a heel stick, but it gives a ballpark figure, they told me. And with that information, I can call the rabbi to get a firm time on the circumcision Sunday afternoon. The rabbi got a little spooked when I told him that A was born at 37 weeks gestation. I am glad that he is cautious with the baby's health. Only it makes a problem calling the caterer and making invitations. Oh well. We do what we can do, right?

Monday, November 5, 2007

New BABY!





Here are some pics of A's birth. I guess those crampy contractions I felt on Saturday night into Sunday were the real thing after all. I went to the hospital to get checked. I was worried because I had a little bloody show and I realized I had not felt kicking for a number of hours. I drove myself to the hospital to get monitored. At that time the contrax were frequent but mildly crampy. That was around 9am.

Got there and when they checked me, I was 2.5 to 3cm dilated with some thickness left in the cervix. That was a big change for me from long, closed and 3cm thick just 3 days prior. The nurse suggested I walk the hallways for a bit and see if things changed. They did. Next check I was 3+cm dilated and fully thinned out. I did more walking, and the contrax came closer and harder. I called DH to get the kids with grandma and get over and meet me in the hospital.

I also decided to get medication. I think I was really not in the mood to be in labor. It was a complete surprise. I didn't want to be there, at that time, going through all that pain. So I got an injection of Nubain when I was about 4cm and that really helped. The lingering pain between contractions completely went away. I continued to make progress quickly and as the Nubain wore off 2 hours later I was 7cm and asked for an epidural. It went in easy and the contrax totally went away, except I got the shakes. That was annoying, but a lot easier to deal with than unrelenting, painful contractions one on top of another. I decided that I had done all natural birthing in the past and I didn't have anything to prove. ;-) The nurse said to call her when I felt the contractions in my bottom. I thought I felt something on one contraction, then called her on the next one. They checked me and yelled for the doctor, the head was *right there*. I pushed exactly 1/2 push and the head was out, followed by a gush of water that soaked the doctor's clothing and the body came out with the gush. The baby came out so smoothly that when they put him on my he was a light gray color, not the deep purple many babies are. He had a full knot in his cord. He must have swam through it at one point in the pg. I was glad that I declined to have my water broken. I think it broke accidentally on my last cervical check at 9 to 10cm. But there was plenty of water up there until the end, giving him a nice cushion. He cried right away and pinked up quickly. He weighed 6 pounds 4 oz., at 3:05pm, at 36w6d gestation. He nursed there on the delivery table and I'm already in love with him. He is so small and sweet. He is quiet and good, too. He barely even squeaks or cries when his diaper is changed.

Thursday, November 1, 2007

Lots of amniotic fluid

I had my OB appointment today. The uterus measured 39cm today, and so the doc and I looked at each other, and he seemed worried. I asked if he thought there might be too much amniotic fluid, and he decided to send me down the corridor for an ultrasound. The ultrasound was fun. Baby measured right on for the due date of November 26, 2007. He appeared to be 6.5 pounds. My cervix measured a full 3cm thick (cast iron, remember?). His head circumference was right at the 50th percentile. The amniotic fluid measured 18.8cm, which is a high-normal measurement. Over 20 would be polyhydramnios. {Edit: a quick read around the internet states that over 25 is polyhydramnios. Normal measurements are between 5 and 25} I asked the doc what that meant, where it came from and what it would change with regard to the treatment of the baby and delivery. He said polyhydramnios could indicate diabetes, and the baby's blood sugar would need to be watched carefully after delivery. My blood sugar 2 mornings ago was 78, so I told him that. He said maybe I should take a few readings 2-hours post-meal, which I said was fine.

Otherwise, my blood pressure was 105/67, the baby's heartbeat was 153bpm, and the urine was negative for protein and sugar. I had read up on the meantime about the urine dip tests, and took the sample differently this time. They said that the urine should not be overly concentrated, so make sure to take a drink 1 hour before the test. I think my prior samples were concentrated because I usually have my doc appts first thing in the morning, only after eating cereal but having nothing extra to drink. Also, they said to make sure it is a mid-stream catch, so that the "protein" found isn't from any leftover pregnancy discharge in the area. It worked better, apparently.

I got one picture from the ultrasound. I will have to see if it will scan in. It is really hard to see what it is. There is a large circle on the right, the back of baby's skull, and a little of the spine from the neck. She could not get a face shot because he is locked into the pelvis right where I said he was, with his face to the back/right.

I was a little bummed to see my cervix was still 3cm thick and closed. I have SO many contractions. I guess this will be a typical pregnancy for me with little to no cervical changes until after 39 weeks. Except with my uterus measuring ahead, I'm lumbering around like I am ALREADY 39 weeks. Oh well. Just a few more weeks to go. I'll try not to complain too much. :-)